Practice guidelines for the diagnosis and management of microcytic anemias due to genetic disorders of iron metabolism or heme synthesis

Author:

Donker Albertine E.1,Raymakers Reinier A. P.2,Vlasveld L. Thom3,van Barneveld Teus4,Terink Rieneke,Dors Natasja5,Brons Paul P. T.6,Knoers Nine V. A. M.7,Swinkels Dorine W.1

Affiliation:

1. Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands;

2. Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands;

3. Department of Internal Medicine, Bronovo Hospital, The Hague, The Netherlands;

4. Netherlands Association of Medical Specialists, Utrecht, The Netherlands;

5. Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands;

6. Department of Pediatric Hemato-Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; and

7. Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands

Abstract

AbstractDuring recent years, our understanding of the pathogenesis of inherited microcytic anemias has gained from the identification of several genes and proteins involved in systemic and cellular iron metabolism and heme syntheses. Numerous case reports illustrate that the implementation of these novel molecular discoveries in clinical practice has increased our understanding of the presentation, diagnosis, and management of these diseases. Integration of these insights into daily clinical practice will reduce delays in establishing a proper diagnosis, invasive and/or costly diagnostic tests, and unnecessary or even detrimental treatments. To assist the clinician, we developed evidence-based multidisciplinary guidelines on the management of rare microcytic anemias due to genetic disorders of iron metabolism and heme synthesis. These genetic disorders may present at all ages, and therefore these guidelines are relevant for pediatricians as well as clinicians who treat adults. This article summarizes these clinical practice guidelines and includes background on pathogenesis, conclusions, and recommendations and a diagnostic flowchart to facilitate using these guidelines in the clinical setting.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference101 articles.

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2. New causes of microcytic anaemia: hereditary disorders of iron homeostasis [in Dutch].;van Rooijen;Ned Tijdschr Geneeskd,2010

3. Recent advances in the understanding of inherited sideroblastic anaemia.;Camaschella;Br J Haematol,2008

4. Congenital sideroblastic anemias: iron and heme lost in mitochondrial translation.;Fleming;Hematology (Am Soc Hematol Educ Program),2011

5. Hereditary sideroblastic anemias: pathophysiology, diagnosis, and treatment.;Camaschella;Semin Hematol,2009

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